This document includes House Committee Amendments incorporated into the bill on Tue, Mar 1, 2016 at 1:47 PM by cynthiahopkin.
1     
COMMITTEE AUTHORITY AMENDMENTS

2     
2016 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Deidre M. Henderson

5     
House Sponsor: Steve Eliason

6     

7     LONG TITLE
8     General Description:
9           This bill modifies provisions related to the rulemaking authority of the Department of
10     Health and certain committees created within the department.
11     Highlighted Provisions:
12          This bill:
13          ▸     modifies the rulemaking authority of the following committees to require
14     concurrence with the Department of Health:
15               •     State Emergency Medical Services Committee;
16               •     Primary Care Grant Committee;
17               •     Health Facility Committee;
18               •     Health Data Committee; and
19               •     Child Care Licensing Committee;
20          ▸     provides that if concurrence with the Department of Health is required in
21     rulemaking, the department has final authority if no concurrence can be reached;
22     and
23          ▸     makes technical changes.
24     Money Appropriated in this Bill:
25          None
26     Other Special Clauses:
27          This bill provides a special effective date.
28     Utah Code Sections Affected:
29     AMENDS:
30          26-1-5, as last amended by Laws of Utah 2011, Chapter 297
31          26-8a-104, as last amended by Laws of Utah 2008, Chapter 382
32          26-8a-106 (Superseded 07/01/16), as last amended by Laws of Utah 2011, Chapter 181
33          26-8a-106 (Effective 07/01/16), as last amended by Laws of Utah 2015, Chapter 141
34          26-10b-106, as enacted by Laws of Utah 2014, Chapter 384
35          26-21-5, as last amended by Laws of Utah 2008, Chapter 382
36          26-21-6, as last amended by Laws of Utah 2012, Chapter 328
37          26-21-8, as last amended by Laws of Utah 2011, Chapter 161
38          26-33a-102, as last amended by Laws of Utah 2011, Chapter 400
39          26-33a-104, as last amended by Laws of Utah 2013, Chapter 167
40          26-33a-106.5, as last amended by Laws of Utah 2014, Chapter 425
41          26-33a-107, as last amended by Laws of Utah 1996, Chapter 201
42          26-33a-109, as last amended by Laws of Utah 2014, Chapter 425
43          26-39-203, as enacted by Laws of Utah 2014, Chapter 322
44          26-39-301, as last amended by Laws of Utah 2014, Chapter 322
45     

46     Be it enacted by the Legislature of the state of Utah:
47          Section 1. Section 26-1-5 is amended to read:
48          26-1-5. Rules of department.
49          (1) (a) Except in areas [regulated by statutory committees created by this title] subject
50     to concurrence between the department and a committee created under this title , the department
51     shall have the power to adopt, amend, or rescind rules necessary to carry out the provisions of
52     this title.
53          (b) If the adoption of rules under a provision of this title is subject to concurrence
54     between the department and a committee created under this title and no concurrence can be
55     reached, the department has final authority to adopt, amend, or rescind rules necessary to carry
56     out the provisions of this title.
56a     Ĥ→ (c) When the provisions of this title require concurrence between the department and a
56b     committee created under this title:
56c          (i) the department shall report to and update the committee on a regular basis related
56d     to matters requiring concurrence; and
56e          (ii) the committee shall review the report submitted by the department under
56f     this Subsection (1)(c) and shall:
56g          (A) concur with the report; or
56h          (B) provide a reason for not concurring with the report and provide an alternative
56i     recommendation to the department. ←Ĥ
57          (2) Rules shall have the force and effect of law and may deal with matters which
58     materially affect the security of health or the preservation and improvement of public health in
59     the state, and any matters as to which jurisdiction is conferred upon the department by this title.
60          (3) Every rule adopted by the department [pursuant to this section], or by the
61     concurrence of the department and a committee established under Section 26-1-7 or 26-1-7.5,
62     shall be subject to Title 63G, Chapter 3, Utah Administrative Rulemaking Act and shall
63     become effective at the time and in the manner provided in that act.
64          (4) If, at the next general session of the Legislature following the filing of a rule with
65     the legislative research director, the Legislature passes a bill disapproving such rule, the rule
66     shall be null and void.
67          (5) The department or the department in concurrence with a committee created under
68     Section 26-1-7 or 26-1-7.5, may not adopt a rule identical to a rule disapproved under
69     Subsection (4) of this section[,] before the beginning of the next general session of the
70     Legislature following the general session at which the rule was disapproved.
71          Section 2. Section 26-8a-104 is amended to read:
72          26-8a-104. Committee advisory duties.
73          The committee shall adopt rules , with the concurrence of the department, in accordance
74     with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, that:
75          (1) establish certification and reciprocity requirements under Section 26-8a-302;
76          (2) establish designation requirements under Section 26-8a-303;
77          (3) promote the development of a statewide emergency medical services system under
78     Section 26-8a-203;
79          (4) establish insurance requirements for ambulance providers;
80          (5) provide guidelines for requiring patient data under Section 26-8a-203;
81          (6) establish criteria for awarding grants under Section 26-8a-207;
82          (7) establish requirements for the coordination of emergency medical services and the
83     medical supervision of emergency medical service providers under Section 26-8a-306; and
84          (8) are necessary to carry out the responsibilities of the committee as specified in other
85     sections of this chapter.
86          Section 3. Section 26-8a-106 (Superseded 07/01/16) is amended to read:
87          26-8a-106 (Superseded 07/01/16). Waiver of rules.
88          (1) Upon application, the [committee or] department, or the committee with the
89     concurrence of the department, may waive the requirements of a rule [it] the department, or the
90     committee with the concurrence of the department, has adopted if:
91          (a) the person applying for the waiver satisfactorily demonstrates that:
92          (i) the waiver is necessary for a pilot project to be undertaken by the applicant;
93          (ii) in the particular situation, the requirement serves no beneficial public purpose; or
94          (iii) circumstances warrant that waiver of the requirement outweighs the public benefit
95     to be gained by adherence to the rule; and
96          (b) for a waiver granted under Subsection (1)(a)(ii) or (iii)[, the committee or
97     department]:
98          (i) the committee or department extends the waiver to similarly situated persons upon
99     application; or
100          (ii) the department, or the committee with the concurrence of the department, amends
101     the rule to be consistent with the waiver.
102          (2) A waiver of education, licensing, or certification requirements may be granted to a
103     veteran, as defined in Section 71-8-1, if the veteran:
104          (a) provides to the committee or department documentation showing military education
105     and training in the field in which certification or licensure is sought; and
106          (b) successfully passes any examination required.
107          (3) No waiver may be granted under this section that is inconsistent with the provisions
108     of this chapter.
109          Section 4. Section 26-8a-106 (Effective 07/01/16) is amended to read:
110          26-8a-106 (Effective 07/01/16). Waiver of rules.
111          (1) Upon application, the [committee or] department, or the committee with the
112     concurrence of the department, may waive the requirements of a rule [it] the department, or the
113     committee with the concurrence of the department, has adopted if:
114          (a) the person applying for the waiver satisfactorily demonstrates that:
115          (i) the waiver is necessary for a pilot project to be undertaken by the applicant;
116          (ii) in the particular situation, the requirement serves no beneficial public purpose; or
117          (iii) circumstances warrant that waiver of the requirement outweighs the public benefit
118     to be gained by adherence to the rule; and
119          (b) for a waiver granted under Subsection (1)(a)(ii) or (iii)[, the committee or
120     department]:
121          (i) the committee or department extends the waiver to similarly situated persons upon
122     application; or
123          (ii) the department, or the committee with the concurrence of the department, amends
124     the rule to be consistent with the waiver.
125          (2) A waiver of education, licensing, or certification requirements may be granted to a
126     veteran, as defined in Section 68-3-12.5, if the veteran:
127          (a) provides to the committee or department documentation showing military education
128     and training in the field in which certification or licensure is sought; and
129          (b) successfully passes any examination required.
130          (3) No waiver may be granted under this section that is inconsistent with the provisions
131     of this chapter.
132          Section 5. Section 26-10b-106 is amended to read:
133          26-10b-106. Primary Care Grant Committee.
134          (1) The Primary Care Grant Committee created in Section 26-1-7 shall:
135          (a) review grant applications forwarded to the committee by the department under
136     Subsection 26-10b-104(1);
137          (b) recommend, to the executive director, grant applications to award under Subsection
138     26-10b-102(1);
139          (c) evaluate:
140          (i) the need for primary health care in different areas of the state;
141          (ii) how the program is addressing those needs; and
142          (iii) the overall effectiveness and efficiency of the program;
143          (d) review annual reports from primary care grant recipients;
144          (e) meet as necessary to carry out its duties, or upon a call by the committee chair or by
145     a majority of committee members; and
146          (f) make rules, with the concurrence of the department, in accordance with Title 63G,
147     Chapter 3, Utah Administrative Rulemaking Act, that govern the committee, including the
148     committee's grant selection criteria.
149          (2) The committee shall consist of:
150          (a) as chair, the executive director or an individual designated by the executive
151     director; and
152          (b) six members appointed by the governor to serve up to two consecutive, two-year
153     terms of office, including:
154          (i) four licensed health care professionals; and
155          (ii) two community advocates who are familiar with a medically underserved
156     population and with health care systems, where at least one is familiar with a rural medically
157     underserved population.
158          (3) The executive director may remove a committee member:
159          (a) if the member is unable or unwilling to carry out the member's assigned
160     responsibilities; or
161          (b) for a rational reason.
162          (4) A committee member may not [be compensated] receive compensation or benefits
163     for the member's service, except a committee member who is not an employee of the
164     department may [be reimbursed for reasonable travel expenses related to the member's
165     committee responsibilities.] receive per diem and travel expenses in accordance with:
166          (a) Section 63A-3-106;
167          (b) Section 63A-3-107; and
168          (c) rules made by the Division of Finance in accordance with Sections 63A-3-106 and
169     63A-3-107.
170          Section 6. Section 26-21-5 is amended to read:
171          26-21-5. Duties of committee.
172          The committee shall:
173          (1) with the concurrence of the department, make rules in accordance with Title 63G,
174     Chapter 3, Utah Administrative Rulemaking Act:
175          (a) for the licensing of health-care facilities; and
176          (b) requiring the submission of architectural plans and specifications for any proposed
177     new health-care facility or renovation to the department for review;
178          (2) approve the information for applications for licensure pursuant to Section 26-21-9;
179          (3) advise the department as requested concerning the interpretation and enforcement
180     of the rules established under this chapter; and
181          (4) advise, consult, cooperate with, and provide technical assistance to other agencies
182     of the state and federal government, and other states and affected groups or persons in carrying
183     out the purposes of this chapter.
184          Section 7. Section 26-21-6 is amended to read:
185          26-21-6. Duties of department.
186          (1) The department shall:
187          (a) enforce rules established pursuant to this chapter;
188          (b) authorize an agent of the department to conduct inspections of health care facilities
189     pursuant to this chapter;
190          (c) collect information authorized by the committee that may be necessary to ensure
191     that adequate health care facilities are available to the public;
192          (d) collect and credit fees for licenses as free revenue;
193          (e) collect and credit fees for conducting plan reviews as dedicated credits;
194          (f) (i) collect and credit fees for conducting clearance under Chapter 21, Part 2,
195     Clearance for Direct Patient Access; and
196          (ii) beginning July 1, 2012:
197          (A) up to $105,000 of the fees collected under Subsection (1)(f)(i) are dedicated
198     credits; and
199          (B) the fees collected for background checks under Subsection 26-21-204(6) and
200     Section 26-21-205 shall be transferred to the Department of Public Safety to reimburse the
201     Department of Public Safety for its costs in conducting the federal background checks;
202          (g) designate an executive secretary from within the department to assist the committee
203     in carrying out its powers and responsibilities;
204          (h) establish reasonable standards for criminal background checks by public and
205     private entities;
206          (i) recognize those public and private entities that meet the standards established
207     pursuant to Subsection (1)(h); and
208          (j) provide necessary administrative and staff support to the committee.
209          (2) The department may:
210          (a) exercise all incidental powers necessary to carry out the purposes of this chapter;
211          (b) review architectural plans and specifications of proposed health care facilities or
212     renovations of health care facilities to ensure that the plans and specifications conform to rules
213     established by the committee; and
214          (c) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
215     make rules as necessary to implement the provisions of this chapter[, except as authority is
216     specifically delegated to the committee].
217          Section 8. Section 26-21-8 is amended to read:
218          26-21-8. License required -- Not assignable or transferable -- Posting --
219     Expiration and renewal -- Time for compliance by operating facilities.
220          (1) (a) A person or governmental unit acting severally or jointly with any other person
221     or governmental unit, may not establish, conduct, or maintain a health care facility in this state
222     without receiving a license from the department as provided by this chapter and the rules [of
223     the committee] adopted pursuant to this chapter .
224          (b) This Subsection (1) does not apply to facilities that are exempt under Section
225     26-21-7.
226          (2) A license issued under this chapter is not assignable or transferable.
227          (3) The current license shall at all times be posted in each health care facility in a place
228     readily visible and accessible to the public.
229          (4) (a) The department may issue a license for a period of time not to exceed 12
230     months from the date of issuance for an abortion clinic and not to exceed 24 months from the
231     date of issuance for other health care facilities that meet the provisions of this chapter and
232     department rules adopted pursuant to this chapter.
233          (b) Each license expires at midnight on the day designated on the license as the
234     expiration date, unless previously revoked by the department.
235          (c) The license shall be renewed upon completion of the application requirements,
236     unless the department finds the health care facility has not complied with the provisions of this
237     chapter or the rules adopted pursuant to this chapter.
238          (5) A license may be issued under this section only for the operation of a specific
239     facility at a specific site by a specific person.
240          (6) Any health care facility in operation at the time of adoption of any applicable rules
241     as provided under this chapter shall be given a reasonable time for compliance as determined
242     by the committee.
243          Section 9. Section 26-33a-102 is amended to read:
244          26-33a-102. Definitions.
245          As used in this chapter:
246          (1) "Committee" means the Health Data Committee created by Section 26-1-7.
247          (2) "Control number" means a number assigned by the committee to an individual's
248     health data as an identifier so that the health data can be disclosed or used in research and
249     statistical analysis without readily identifying the individual.
250          (3) "Data supplier" means a health care facility, health care provider, self-funded
251     employer, third-party payor, health maintenance organization, or government department which
252     could reasonably be expected to provide health data under this chapter.
253          (4) "Disclosure" or "disclose" means the communication of health care data to any
254     individual or organization outside the committee, its staff, and contracting agencies.
255          (5) "Executive director" means the director of the department.
256          (6) (a) "Health care facility" means a facility that is licensed by the department under
257     Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act. [The committee]
258           (b) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
259     committee, with the concurrence of the department, may by rule add, delete, or modify the list
260     of facilities that come within this definition for purposes of this chapter.
261          (7) "Health care provider" means any person, partnership, association, corporation, or
262     other facility or institution that renders or causes to be rendered health care or professional
263     services as a physician, registered nurse, licensed practical nurse, nurse-midwife, dentist, dental
264     hygienist, optometrist, clinical laboratory technologist, pharmacist, physical therapist, podiatric
265     physician, psychologist, chiropractic physician, naturopathic physician, osteopathic physician,
266     osteopathic physician and surgeon, audiologist, speech pathologist, certified social worker,
267     social service worker, social service aide, marriage and family counselor, or practitioner of
268     obstetrics, and others rendering similar care and services relating to or arising out of the health
269     needs of persons or groups of persons, and officers, employees, or agents of any of the above
270     acting in the course and scope of their employment.
271          (8) "Health data" means information relating to the health status of individuals, health
272     services delivered, the availability of health manpower and facilities, and the use and costs of
273     resources and services to the consumer, except vital records as defined in Section 26-2-2 shall
274     be excluded.
275          (9) "Health maintenance organization" has the meaning set forth in Section 31A-8-101.
276          (10) "Identifiable health data" means any item, collection, or grouping of health data
277     that makes the individual supplying or described in the health data identifiable.
278          (11) "Individual" means a natural person.
279          (12) "Organization" means any corporation, association, partnership, agency,
280     department, unit, or other legally constituted institution or entity, or part thereof.
281          (13) "Research and statistical analysis" means activities using health data analysis
282     including:
283          (a) describing the group characteristics of individuals or organizations;
284          (b) analyzing the noncompliance among the various characteristics of individuals or
285     organizations;
286          (c) conducting statistical procedures or studies to improve the quality of health data;
287          (d) designing sample surveys and selecting samples of individuals or organizations;
288     and
289          (e) preparing and publishing reports describing these matters.
290          (14) "Self-funded employer" means an employer who provides for the payment of
291     health care services for employees directly from the employer's funds, thereby assuming the
292     financial risks rather than passing them on to an outside insurer through premium payments.
293          (15) "Plan" means the plan developed and adopted by the Health Data Committee
294     under Section 26-33a-104.
295          (16) "Third party payor" means:
296          (a) an insurer offering a health benefit plan, as defined by Section 31A-1-301, to at
297     least 2,500 enrollees in the state;
298          (b) a nonprofit health service insurance corporation licensed under Title 31A, Chapter
299     7, Nonprofit Health Service Insurance Corporations;
300          (c) a program funded or administered by Utah for the provision of health care services,
301     including the Medicaid and medical assistance programs described in Chapter 18, Medical
302     Assistance Act; and
303          (d) a corporation, organization, association, entity, or person:
304          (i) which administers or offers a health benefit plan to at least 2,500 enrollees in the
305     state; and
306          (ii) which is required by administrative rule adopted by the department in accordance
307     with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to supply health data to the
308     committee.
309          Section 10. Section 26-33a-104 is amended to read:
310          26-33a-104. Purpose, powers, and duties of the committee.
311          (1) The purpose of the committee is to direct a statewide effort to collect, analyze, and
312     distribute health care data to facilitate the promotion and accessibility of quality and
313     cost-effective health care and also to facilitate interaction among those with concern for health
314     care issues.
315          (2) The committee shall:
316          (a) with the concurrence of the department and in accordance with Title 63G, Chapter
317     3, Utah Administrative Rulemaking Act, develop and adopt by rule, following public hearing
318     and comment, a health data plan that shall among its elements:
319          (i) identify the key health care issues, questions, and problems amenable to resolution
320     or improvement through better data, more extensive or careful analysis, or improved
321     dissemination of health data;
322          (ii) document existing health data activities in the state to collect, organize, or make
323     available types of data pertinent to the needs identified in Subsection (2)(a)(i);
324          (iii) describe and prioritize the actions suitable for the committee to take in response to
325     the needs identified in Subsection (2)(a)(i) in order to obtain or to facilitate the obtaining of
326     needed data, and to encourage improvements in existing data collection, interpretation, and
327     reporting activities, and indicate how those actions relate to the activities identified under
328     Subsection (2)(a)(ii);
329          (iv) detail the types of data needed for the committee's work, the intended data
330     suppliers, and the form in which such data are to be supplied, noting the consideration given to
331     the potential alternative sources and forms of such data and to the estimated cost to the
332     individual suppliers as well as to the department of acquiring these data in the proposed
333     manner; the plan shall reasonably demonstrate that the committee has attempted to maximize
334     cost-effectiveness in the data acquisition approaches selected;
335          (v) describe the types and methods of validation to be performed to assure data validity
336     and reliability;
337          (vi) explain the intended uses of and expected benefits to be derived from the data
338     specified in Subsection (2)(a)(iv), including the contemplated tabulation formats and analysis
339     methods; the benefits described shall demonstrably relate to one or more of the following:
340          (A) promoting quality health care;
341          (B) managing health care costs; or
342          (C) improving access to health care services;
343          (vii) describe the expected processes for interpretation and analysis of the data flowing
344     to the committee; noting specifically the types of expertise and participation to be sought in
345     those processes; and
346          (viii) describe the types of reports to be made available by the committee and the
347     intended audiences and uses;
348          (b) have the authority to collect, validate, analyze, and present health data in
349     accordance with the plan while protecting individual privacy through the use of a control
350     number as the health data identifier;
351          (c) evaluate existing identification coding methods and, if necessary, require by rule
352     adopted in accordance with Subsection (3), that health data suppliers use a uniform system for
353     identification of patients, health care facilities, and health care providers on health data they
354     submit under this chapter; and
355          (d) advise, consult, contract, and cooperate with any corporation, association, or other
356     entity for the collection, analysis, processing, or reporting of health data identified by control
357     number only in accordance with the plan.
358          (3) [The] In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking
359     Act, the committee , with the concurrence of the department, may adopt rules to carry out the
360     provisions of this chapter [in accordance with Title 63G, Chapter 3, Utah Administrative
361     Rulemaking Act].
362          (4) Except for data collection, analysis, and validation functions described in this
363     section, nothing in this chapter shall be construed to authorize or permit the committee to
364     perform regulatory functions which are delegated by law to other agencies of the state or
365     federal governments or to perform quality assurance or medical record audit functions that
366     health care facilities, health care providers, or third party payors are required to conduct to
367     comply with federal or state law. The committee may not recommend or determine whether a
368     health care provider, health care facility, third party payor, or self-funded employer is in
369     compliance with federal or state laws including federal or state licensure, insurance,
370     reimbursement, tax, malpractice, or quality assurance statutes or common law.
371          (5) Nothing in this chapter shall be construed to require a data supplier to supply health
372     data identifying a patient by name or describing detail on a patient beyond that needed to
373     achieve the approved purposes included in the plan.
374          (6) No request for health data shall be made of health care providers and other data
375     suppliers until a plan for the use of such health data has been adopted.
376          (7) If a proposed request for health data imposes unreasonable costs on a data supplier,
377     due consideration shall be given by the committee to altering the request. If the request is not
378     altered, the committee shall pay the costs incurred by the data supplier associated with
379     satisfying the request that are demonstrated by the data supplier to be unreasonable.
380          (8) After a plan is adopted as provided in Section 26-33a-106.1, the committee may
381     require any data supplier to submit fee schedules, maximum allowable costs, area prevailing
382     costs, terms of contracts, discounts, fixed reimbursement arrangements, capitations, or other
383     specific arrangements for reimbursement to a health care provider.
384          (9) The committee may not publish any health data collected under Subsection (8) that
385     would disclose specific terms of contracts, discounts, or fixed reimbursement arrangements, or
386     other specific reimbursement arrangements between an individual provider and a specific
387     payer.
388          (10) Nothing in Subsection (8) shall prevent the committee from requiring the
389     submission of health data on the reimbursements actually made to health care providers from
390     any source of payment, including consumers.
391          Section 11. Section 26-33a-106.5 is amended to read:
392          26-33a-106.5. Comparative analyses.
393          (1) The committee may publish compilations or reports that compare and identify
394     health care providers or data suppliers from the data it collects under this chapter or from any
395     other source.
396          (2) (a) Except as provided in Subsection (7)(c), the committee shall publish
397     compilations or reports from the data it collects under this chapter or from any other source
398     which:
399          (i) contain the information described in Subsection (2)(b); and
400          (ii) compare and identify by name at least a majority of the health care facilities, health
401     care plans, and institutions in the state.
402          (b) Except as provided in Subsection (7)(c), the report required by this Subsection (2)
403     shall:
404          (i) be published at least annually; and
405          (ii) contain comparisons based on at least the following factors:
406          (A) nationally or other generally recognized quality standards;
407          (B) charges; and
408          (C) nationally recognized patient safety standards.
409          (3) The committee may contract with a private, independent analyst to evaluate the
410     standard comparative reports of the committee that identify, compare, or rank the performance
411     of data suppliers by name. The evaluation shall include a validation of statistical
412     methodologies, limitations, appropriateness of use, and comparisons using standard health
413     services research practice. The analyst shall be experienced in analyzing large databases from
414     multiple data suppliers and in evaluating health care issues of cost, quality, and access. The
415     results of the analyst's evaluation shall be released to the public before the standard
416     comparative analysis upon which it is based may be published by the committee.
417          (4) [The] In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking
418     Act, the committee , with the concurrence of the department, shall adopt by rule a timetable for
419     the collection and analysis of data from multiple types of data suppliers.
420          (5) The comparative analysis required under Subsection (2) shall be available:
421          (a) free of charge and easily accessible to the public; and
422          (b) on the Health Insurance Exchange either directly or through a link.
423          (6) (a) The department shall include in the report required by Subsection (2)(b), or
424     include in a separate report, comparative information on commonly recognized or generally
425     agreed upon measures of cost and quality identified in accordance with Subsection (7), for:
426          (i) routine and preventive care; and
427          (ii) the treatment of diabetes, heart disease, and other illnesses or conditions as
428     determined by the committee.
429          (b) The comparative information required by Subsection (6)(a) shall be based on data
430     collected under Subsection (2) and clinical data that may be available to the committee, and
431     shall compare:
432          (i) beginning December 31, 2014, results for health care facilities or institutions;
433          (ii) beginning December 31, 2014, results for health care providers by geographic
434     regions of the state;
435          (iii) beginning July 1, 2016, a clinic's aggregate results for a physician who practices at
436     a clinic with five or more physicians; and
437          (iv) beginning July 1, 2016, a geographic region's aggregate results for a physician who
438     practices at a clinic with less than five physicians, unless the physician requests physician-level
439     data to be published on a clinic level.
440          (c) The department:
441          (i) may publish information required by this Subsection (6) directly or through one or
442     more nonprofit, community-based health data organizations;
443          (ii) may use a private, independent analyst under Subsection (3) in preparing the report
444     required by this section; and
445          (iii) shall identify and report to the Legislature's Health and Human Services Interim
446     Committee by July 1, 2014, and every July 1 thereafter until July 1, 2019, at least three new
447     measures of quality to be added to the report each year.
448          (d) A report published by the department under this Subsection (6):
449          (i) is subject to the requirements of Section 26-33a-107; and
450          (ii) shall, prior to being published by the department, be submitted to a neutral,
451     non-biased entity with a broad base of support from health care payers and health care
452     providers in accordance with Subsection (7) for the purpose of validating the report.
453          (7) (a) The Health Data Committee shall, through the department, for purposes of
454     Subsection (6)(a), use the quality measures that are developed and agreed upon by a neutral,
455     non-biased entity with a broad base of support from health care payers and health care
456     providers.
457          (b) If the entity described in Subsection (7)(a) does not submit the quality measures,
458     the department may select the appropriate number of quality measures for purposes of the
459     report required by Subsection (6).
460          (c) (i) For purposes of the reports published on or after July 1, 2014, the department
461     may not compare individual facilities or clinics as described in Subsections (6)(b)(i) through
462     (iv) if the department determines that the data available to the department can not be
463     appropriately validated, does not represent nationally recognized measures, does not reflect the
464     mix of cases seen at a clinic or facility, or is not sufficient for the purposes of comparing
465     providers.
466          (ii) The department shall report to the Legislature's Executive Appropriations
467     Committee prior to making a determination not to publish a report under Subsection (7)(c)(i).
468          Section 12. Section 26-33a-107 is amended to read:
469          26-33a-107. Limitations on release of reports.
470          The committee may not release a compilation or report that compares and identifies
471     health care providers or data suppliers unless it:
472          (1) allows the data supplier and the health care provider to verify the accuracy of the
473     information submitted to the committee and submit to the committee any corrections of errors
474     with supporting evidence and comments within a reasonable period of time to be established by
475     rule , with the concurrence of the department, in accordance with Title 63G, Chapter 3, Utah
476     Administrative Rulemaking Act ;
477          (2) corrects data found to be in error; and
478          (3) allows the data supplier a reasonable amount of time prior to publication to review
479     the committee's interpretation of the data and prepare a response.
480          Section 13. Section 26-33a-109 is amended to read:
481          26-33a-109. Exceptions to prohibition on disclosure of identifiable health data.
482          (1) The committee may not disclose any identifiable health data unless:
483          (a) the individual has authorized the disclosure; or
484          (b) the disclosure complies with the provisions of:
485          (i) this section;
486          (ii) insurance enrollment and coordination of benefits under Subsection
487     26-33a-106.1(1)(d); or
488          (iii) risk adjusting under Subsection 26-33a-106.1(1)(b).
489          (2) The committee shall consider the following when responding to a request for
490     disclosure of information that may include identifiable health data:
491          (a) whether the request comes from a person after that person has received approval to
492     do the specific research and statistical work from an institutional review board; and
493          (b) whether the requesting entity complies with the provisions of Subsection (3).
494          (3) A request for disclosure of information that may include identifiable health data
495     shall:
496          (a) be for a specified period; or
497          (b) be solely for bona fide research and statistical purposes as determined in
498     accordance with administrative rules adopted by the department in accordance with Title 63G,
499     Chapter 3, Utah Administrative Rulemaking Act , which shall require:
500          (i) the requesting entity to demonstrate to the department that the data is required for
501     the research and statistical purposes proposed by the requesting entity; and
502          (ii) the requesting entity to enter into a written agreement satisfactory to the department
503     to protect the data in accordance with this chapter or other applicable law.
504          (4) A person accessing identifiable health data pursuant to Subsection (3) may not
505     further disclose the identifiable health data:
506          (a) without prior approval of the department; and
507          (b) unless the identifiable health data is disclosed or identified by control number only.
508          Section 14. Section 26-39-203 is amended to read:
509          26-39-203. Duties of the Child Care Center Licensing Committee.
510          (1) The licensing committee shall:
511          (a) in concurrence with the department and in accordance with Title 63G, Chapter 3,
512     Utah Administrative Rulemaking Act, make rules that govern center based child care as
513     necessary to protect qualifying children's common needs for a safe and healthy environment, to
514     provide for:
515          (i) adequate facilities and equipment; and
516          (ii) competent caregivers considering the age of the children and the type of program
517     offered by the licensee;
518          (b) in concurrence with the department and in accordance with Title 63G, Chapter 3,
519     Utah Administrative Rulemaking Act, make rules necessary to carry out the purposes of this
520     chapter that govern center based child care, in the following areas:
521          (i) requirements for applications, the application process, and compliance with other
522     applicable statutes and rules;
523          (ii) documentation and policies and procedures that providers shall have in place in
524     order to be licensed, in accordance with Subsection (1);
525          (iii) categories, classifications, and duration of initial and ongoing licenses;
526          (iv) changes of ownership or name, changes in licensure status, and changes in
527     operational status;
528          (v) license expiration and renewal, contents, and posting requirements;
529          (vi) procedures for inspections, complaint resolution, disciplinary actions, and other
530     procedural measures to encourage and assure compliance with statute and rule; and
531          (vii) guidelines necessary to assure consistency and appropriateness in the regulation
532     and discipline of licensees;
533          (c) advise the department on the administration of a matter affecting center based child
534     care;
535          (d) advise and assist the department in conducting center based child care provider
536     seminars; and
537          (e) perform other duties as provided under Section 26-39-301.
538          (2) (a) The licensing committee may not enforce the rules adopted under this section.
539          (b) The department shall enforce the rules adopted under this section in accordance
540     with Section 26-39-301.
541          Section 15. Section 26-39-301 is amended to read:
542          26-39-301. Duties of the department -- Enforcement of chapter -- Licensing
543     committee requirements.
544          (1) With regard to residential child care licensed or certified under this chapter, the
545     department may:
546          (a) make and enforce rules to implement this chapter and, as necessary to protect
547     qualifying children's common needs for a safe and healthy environment, to provide for:
548          (i) adequate facilities and equipment; and
549          (ii) competent caregivers considering the age of the children and the type of program
550     offered by the licensee;
551          (b) make and enforce rules necessary to carry out the purposes of this chapter, in the
552     following areas:
553          (i) requirements for applications, the application process, and compliance with other
554     applicable statutes and rules;
555          (ii) documentation and policies and procedures that providers shall have in place in
556     order to be licensed, in accordance with Subsection (1)(a);
557          (iii) categories, classifications, and duration of initial and ongoing licenses;
558          (iv) changes of ownership or name, changes in licensure status, and changes in
559     operational status;
560          (v) license expiration and renewal, contents, and posting requirements;
561          (vi) procedures for inspections, complaint resolution, disciplinary actions, and other
562     procedural measures to encourage and assure compliance with statute and rule; and
563          (vii) guidelines necessary to assure consistency and appropriateness in the regulation
564     and discipline of licensees; and
565          (c) set and collect licensing and other fees in accordance with Section 26-1-6.
566          (2) The department shall enforce the rules established by the licensing committee, with
567     the concurrence of the department, for center based child care.
568          (3) Rules made under this chapter by the department, or the licensing committee with
569     the concurrence of the department, shall be made in accordance with Title 63G, Chapter 3,
570     Utah Administrative Rulemaking Act.
571          (4) (a) The licensing committee and the department may not regulate educational
572     curricula, academic methods, or the educational philosophy or approach of the provider.
573          (b) The licensing committee and the department shall allow for a broad range of
574     educational training and academic background in certification or qualification of child day care
575     directors.
576          (5) In licensing and regulating child care programs, the licensing committee and the
577     department shall reasonably balance the benefits and burdens of each regulation and, by rule,
578     provide for a range of licensure, depending upon the needs and different levels and types of
579     child care provided.
580          (6) Notwithstanding the definition of "qualifying child" in Section 26-39-102, the
581     licensing committee and the department shall count children through age 12 and children with
582     disabilities through age 18 toward the minimum square footage requirement for indoor and
583     outdoor areas, including the child of:
584          (a) a licensed residential child care provider; or
585          (b) an owner or employee of a licensed child care center.
586          (7) Notwithstanding Subsection (1)(a)(i), the licensing committee and the department
587     may not exclude floor space used for furniture, fixtures, or equipment from the minimum
588     square footage requirement for indoor and outdoor areas if the furniture, fixture, or equipment
589     is used:
590          (a) by qualifying children;
591          (b) for the care of qualifying children; or
592          (c) to store classroom materials.
593          (8) (a) A child care center constructed prior to January 1, 2004, and licensed and
594     operated as a child care center continuously since January 1, 2004, is exempt from the licensing
595     committee's and the department's group size restrictions, if the child to caregiver ratios are
596     maintained, and adequate square footage is maintained for specific classrooms.
597          (b) An exemption granted under Subsection (7)(a) is transferrable to subsequent
598     licensed operators at the center if a licensed child care center is continuously maintained at the
599     center.
600          (9) The licensing committee [and the] , with the concurrence of the department, shall
601     develop, by rule, a five-year phased-in compliance schedule for playground equipment safety
602     standards.
603          (10) Nothing in this chapter may be interpreted to grant a municipality or county the
604     authority to license or certify a child care program.
605          Section 16. Effective date.
606          This bill takes effect on May 10, 2016, except that the amendments to Section
607     26-8a-106 (Effective 07/01/16) take effect on July 1, 2016.




Legislative Review Note
Office of Legislative Research and General Counsel